Tuberculosis in patients with chronic renal failure

• Main Authors: Flávio Jota de Paula, Luiz Sérgio Fonseca de Azevedo, Luiz Estevam Ianhez, João Egidio Romão Júnior, Pedro Renato Chocair, Emil Sabbaga
• Format: Article
• Language: English
• Published: Universidade de São Paulo 1987-06-01
• Series: Revista do Instituto de Medicina Tropical de São Paulo
• Subjects: Tuberculosis; Chronic renal failure; Dialysis
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46651987000300002&lng=en&tlng=en

Nine cases of tuberculosis (TB) were diagnosed among 800 uremic patients, followed-up during 11 years, a prevalence of 1125%, 2.5 times higher than that in the general population. Six patients (66.7%) had lymph node involvement (4 cervical and 2 mediastinal). Three patients (33.3%) had pulmonary involvement (2 pleuro-pulmonary and 1 bilateral apical pulmonary). Eight patients were undergoing dialysis and 1 was pre-dialytic. The duration of dialysis ranged from 1 to 60 months. Three patients had previously received immunosuppressive drugs for unsuccessful renal transplantation. Daily fever was present in all but one patient; he was asymptomatic and TB was suspected after routine chest radiography. Biopsy was the diagnostic procedure in 7 patients (77.8%), four by direct cervical lymph node biopsy, 2 by mediastinal, performed by mediastinoscopy and 1 by pleural biopsy. In 2 other patients TB was confirmed by the presence of tubercle bacilli; in sputum (1 patient) and in a bronchial flushing specimen (the other patient). Triple therapy was used in all patients (isoniazid and ethambutol in all), plus rifampicin in 8 and streptomycin in 1. One patient had jaundice and another had optical neuritis. Five patients were cured. The other four died during treatment of causes unrelated to TB or its treatment.